Title

Author

Degree Name

DrPH (Doctor of Public Health)

Program

Public Health

Date of Award

5-2016

Committee Chair or Co-Chairs

Deborah Slawson

Committee Members

Robert Pack, Megan Quinn, Beth Bailey

Abstract

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. (Aim 1). An evaluation of psychological, sociocultural, and socioeconomic variables as they relate to both current and historical IPV in pregnant women presenting for prenatal care was conducted (Aim 2), and the results from this evaluation were used to model significant IPV influences to determine pregnancy predictors in the study sample when historical and current IPV is present (Aim 3). Percent prevalence of self-reported IPV was higher in the TIPS sample for Carter, Greene, Hawkins, Johnson, Sullivan, Washington, and Unicoi counties, when compared to criminal reports for State of Tennessee IPV victimization rates, and the rate per 1,000 IPV victimization rate was also higher in the TIPS sample when compared to the criminal report for the U.S. Self-esteem, social, support, stress, substance abuse, and alcohol were positive as independent effects for predicting IPV via ordinal regression; however, when evaluated via multinomial logical regression with controls for age, race, income, education, marital status, whether or not a pregnancy was planned, and parity, this effect was no longer noted. Unplanned pregnancies and lower education were significant control variables in these evaluations. The lack of support for predictive ability of those selected psychological and sociocultural variables for IPV only underscores the importance of taking into consideration the uniqueness of various populations and across various regions such as Appalachia. The influences of unplanned pregnancy and lower education may be significant predictors if IPV in pregnant women in Appalachia and warrant further research.